Overcoming medication stigma in peer recovery: A new paradigm

ABSTRACT

Background: Treatment for opioid use disorder involving opioid-based pharmacotherapies is considered most effective when accompanied by psychosocial interventions. Peer-led support groups are widely available and have been described by many as fundamental to the recovery process. However, some individuals using medications face stigma in these settings, which can be contradictory and counterproductive to their recovery. Methods: This paper describes the development of the “Ability, Inspiration and Motivation” or “AIM” group, an alternative peer support group that aims to remove medication stigma from peer recovery. Qualitative interviews with staff, peers, and clients of a community-based buprenorphine treatment program were used to establish the core components of the curriculum to support client needs. Results: Staff, peers, and clients of the buprenorphine program indicated a need and desire to establish a peer recovery group that recognizes persons on medication as being in recovery and destigmatizes use of medication to treat opioid addiction. A respectful environment, holistic perspective on health, spirituality, sharing, and celebration were all established as necessary pillars of the AIM group curriculum. Conclusions: The community-based effort to establish and develop the AIM group demonstrates that combining the strengths of a peer support with evidence-based medication treatment is both possible and desirable. Shifting the culture of peer recovery groups to support the use of medications may have implications for improving treatment retention and should be considered as a potential strategy to reduce the burden of the opioid epidemic.

KEYWORDS:

• Buprenorphine
• medication treatment
• opioid use disorders
• overdose prevention
• peer support
• self-help
• stigma
• 12-step

Acknowledgments

The authors would like to thank William Jones, Tina P. Jones, and Coriless Jones for their efforts in the development and operation of the AIM recovery group and their constant dedication to Dee's Place clients.

Author contributions

N.K. analyzed results of the participant surveys and drafted the manuscript. T.N. and M.N. participated in process of developing the AIM model, designed and carried out the participant survey, and contributed to the manuscript. D.A. and M.F. contributed to the planning process and design of the AIM paradigm and edited the manuscript. All authors reviewed and approved of the final contents of the manuscript.

Additional information

Funding

Funding for the AIM project and research was provided by the Zanvyl and Isabelle Krieger Fund and by Behavioral Health Systems Baltimore (grant no. 16-114-5704-000). Noa Krawczyk received support from the National Institute of Drug Abuse Training Grant T32-DA007293 (Principal Investigator: Renee Johnson). The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.